Mark T Juarez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2017015964 Issued in MO

Practice address

1731 E North Ave
Belton, MO 64012-2130

Phone

(816) 322-3506

Fax

(816) 322-3282

NPI assigned

Jul 28, 2015

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John Holmes, D.D.S., Belton Modern Dentistry, P.C.

  dba Belton Modern Dentistry

  • General Practice Dentistry
  • Belton, MO
  • NPI 1376895094
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407231798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10316 GODDARD ST APT 119",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662143079",
            "telephone_number": "614-439-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 E NORTH AVE",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640122130",
            "telephone_number": "816-322-3506",
            "fax_number": "816-322-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7450 Quivira Rd",
            "address_purpose": "LOCATION",
            "city": "Shawnee Mission",
            "state": "KS",
            "postal_code": "662163526",
            "country_code": "US",
            "telephone_number": "913-217-7536",
            "fax_number": "913-766-1019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "MARK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61252",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2017015964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jennings, R.N.
• John Holmes, D.D.S., Belton Modern Dentistry, P.C. (Belton Modern Dentistry)
• Danny Wayne Johnson, LPC
• Michelle Lynn Jones
• Molly Ad Jones, FNP
• Juli Hanz Care Services LLC
• Robert Alan Jundt, PTA
• Atiya Junius, APRN
• Justin Bashor DC LLC (Chiropractic Health Center Belton)
• Kansas City Vamc

• General Practice Dentistry in Belton, MO
• Providers in Belton, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.